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1961 Beaver Dam Ct5 / 7? + RESIDENTIAL SUILDING Permit Application City Of Eagan 3830 Pilvt Knab Road, Eagan Mn 55122 Telephane # 651-675-5675 FAX # 651-675-5694 ? `-1 l . `l 5 New ConstrucHon Requiremenis RemodeWRepair Reauirements Office Use Onlv 3 registered site surveys showing sq. ft ot lot sq. ft ot house; and all roofed areas 2 copies of plan Cert oi Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations (or healed addi6ons 7ree Pres Plan Recd 2 copies of plan showing beam & wiridow sizes; poured found design, etc. 1 siie survey far addifions & decks Tree Pres Not Reqd 1 set of Energy Calculataons Addition - indreate rf on-srte sepdc sysfem _ On-site Septic System 3 coples of Tree Presenration Plan ii lot platted after 711193 Rim Joist Detail Options selectian sheet {hidgs with 3 or less units Date ?-, ! ?3I 03 Canstrnction Cost z 00 Site Address UnitlSte # Description of Work r`^e- Multi-Family BZdg ? Y(-Z'N Fireplace(s) _ 0 --/1 - 2 Property Owner ;r•--??'.?? ? `? c? ?? ?h?.?,-? ??_?-a--? Tetephone # ?S Contraetor Address O2rxqv-v- C-5 _ City State Zip 1Y?` Telephane #((?s1 ? COMPLETE THiS AREA 4NLY IF C4NSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category _i Minnesota Rules 7672 Energy GOde CategOry . Residentiai Ventilation Category 1 Worksheet ? • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calcufations Submitted Licensed Piumber Mechanical Contractor Sewer/Water Contractor Telephane # ( Telephane # ( Telephone # ( I hereby apply far a Residential Building Permit and acknawledge that the information is complete and accurate; that the work will be in conformance with the ardinances and codes of the City of Eagan and the State of NIN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. S Applicant's rinted Name Applicant' ignature oFFIcE usE omLY Sub Types ? 01 FaundaGon ? 02 SF Dwelling 0 03 01 of _ plex ? 04 02-plex ? 05 a3-plex ? 06 04-p4ex ? 07 05-plex ? 13 16-plex 0 20 Poai ? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.) 0 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) 0 10 08-plex ? 18 Deck 0 23 Porch (screen/gazebo) ? 11 10-plex 0 19 Lower Level ? 24 Storm Damage ? 12 12-plex Plbg_Y or,_, _, N? 25 MRSCellaneous 0 30 Accessory Bldg 0 31 Ext. Alt - Multi 0 33 Ext. Alt - SF 0 36 Multi Misc. Work Types ? 31 New ? 35 !nt Improvement ? 38 Dempfish (Interior) 0 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demofish (Foundatian) 0 45 Fire Repair ? 33 Alteration ? 37 Demolish (BIdg)' ? 43 Reroaf 0 46 WirsdowslDoors ? 34 Replacement 'Demoiition (Errtire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units 5q. Ft. PRV Nbr. af Bldgs Length Fire Sprinklered Type vf Const Width REQUIRED INSPECTIONS - Faotings (new bldg) FinaUCA. _ Footings (deck) Final/No C.O. _ Footings (addition) _ plurnbing _ Foundarion HVAG _ Drain Tile Other Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final _ Framing _ _ _ Siding Stucco Stone _ - Fireplace _ R.I. Air _ Test - Final ? Windows (new/replacement) - Tnsulation _ Retaining WaII Approved Sy Base Fee Surcharge Plan Review - MCIES SAC City SAC Utility Connection Charge 5&W Permit & 5urcharge l"reatment Plant License Search Copiss Other Tota! Building Inspector , cirY oF EAGAN `- 8795 Pilot Knob Rood Ea,en, MN 55122 N0 7788 PHONE: 464-81 QO &42 / - ? BUILDING PERMIT Reteipt # rn To ba uaed for R?M DEL• Est. Volue $2,000 Dote FehTU= 2 , 19_83-- Site Address 1961 BeSVe7c DSID COt1tt Ered ? Occuponcy R-3 Lot 53 BI«k 1 5ec/Sub. MeadOwl$nd Alter Zoning R-1 parcel # lU 4$0 SQ 063 01 Repoir p Fire Zone MA Enlorga Q Type of Const. vfl o c Name David J. MCI,@B.Ii Move p 5tories w Z ] ress 196I Beaver Dam Ceurt Demoiiah p Length NA ? phone 454-77S6 Grode ? Depth N& Sq. Ft. ce 0 Narrie Owner Apprornls Fees ?F ?' Address f- r:... Name _ Address Phone 1 hereby acknowledge thot 1 hove read this oppiicction ond state that the information is correct and ogree to to ply with all applicobla Stcte of Minnesoto Statutes and City of`E n Orcjinonce Signoture of Pertnittee ? yd J. ??gn /1 Building Permit is issued to: oll work shail be done in accordonce with all opplicablq.?tate of Mii Buiidinp Officiol Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. ' APC Permit 32 _ 5n Surcharge Lno Plcn check SAC Wuter Conn. Water Meter Road Unit Totol $33•SO on the express tondition thot Statutes ond City of Engan Ordinances. * crrx GaN- , '::?t' Knob -Road ` RERMIT.'NO tEogon, MN 55122,• ' DATE:` , r. Zoning TUt . No ofiUrnts Owner, • .TQ86p12 r. x ? - ? Address: Site Address: rya: Z:iciWestern 1'ecy . • ' - Rlumber m ,. Meter No..: - ' Connect,ionwCharg:e ?.. xX Size:. ??.A¢tount =Depo?`sit? ??. Rea,der No Permit ;Fee1? 1, ogiee to'eomp? with thes.CiFy ofREugon ??,?, ; SurchaFg? ?`? L?? Ordinanees ?. r .' . ?y * ?Misc r,?Charges.`-??? cirrr- EaoAN SEWER SERVICE PERMfT 3799l?ilot Knob Road PERMIT NO.: 4290, `Ecgan, MN 55122 DATE: Zoning: F.ZI No. of Units: 1 ' Owner: Joserh ?'j 1 ler ' Address: Site Address: 1961 Beaver L'am Court LE3 BI MAarl0*j,6tiA Plumber: *?401wo-.sLerr. *'ech _ .r:y? ' y; ,: . `; •?11.'??'? 10/1180 21152 1 agma to eomply with the City of Eagon Ordinanees. By . Dote of insp.: Insp. .. x?: ' ConnecYion Ckarge; 4 O*<- Account Depasit: s Permit Fee: Surcharge:. - Misc. Charges: -?a, j?- 4 - Totalc Date ,Puid GiT'1f t]F EAQiAN 3830 Pilot Knob Road, P.O. Box 21-198, Eagam, MN 55121 NQ.` 4 PHBNE: 454-8100 BUILQING PERMIT Rectiot # To be used Ear DECR . Est Value $2,000. Date 4UNE 23 ,19 86 Site Adrfress L961 BLhVSR 1]AM C'I' Erect EK Occupancy Lot-(ifi.38lock ?Y Sec/Stib. t?At}f?6?.ANdS I.9°lRemoelel ? 2or?ing ' Repair ? Typs oi Const. Parcel Na. Addition ? Na. Staries KT3RT LA?nTTON Mave . ? Leng? 1, 6 ? Name Demalish ? Depth o Address S?$ 4Ps6--5fi77 Int lmpr. ? Sq. Ft City Phone 690 7252 (W) Instal! ? °C N S?sAMP APprovaFs Fen z p ame U ? Address . City Phone a Name . ? q Add re5s Clty Phone I hereby acknowfedge fhat I have read th' . appliaation and state tha# the information is oorrect and agcee 3o p with all applicable State of lulinnesota 5tatutes and Ci a inances r? Signature.of Permittee A Buildin Permit is issued tp• 9 • all work shall be dane in accnrdance with a11 Building of Minn 4ta , - et. ?.-f Asse&sment Permit gaa• av Water & Sew. Surcharge ? • ?? Pvlice Plan Review. Fira SAC Eng. VWater Conn. Planner - Water Meter Cauncil - Rosd Unit 13ldg..off.?.?/231B Tr. PI: APC Parka Var. Date Copi TOtal on the express car?dMon toot Siatyifea.aua City- af. Eagan 4rcfirtattices. 44-` . FeraiM Na. lyrmq Motdir ow Talephr+nW # ? E?ie SORMW ?4?spsoNen L'/?Is Ir? . Gc? Fao?nqs 1 ?? ?9,,,? Foa?s il ?Foan?IMlp? PrN?un? ? Rft-jh My. Rouph H1a. l1161lI. k"foto fNlsi Htg. Flwal Pbs. 91dy. Finid cart. Oec. Dock Ftg. Daek Frng. I-,t7$7 'Weli - Osaerlbe I.oeMonm Pr. Dkp. ??t' w ? W C?Y AF EA?w..... ?,' ,.; I^ ?s ? K,?? ? 5.,.?,+w? ssin T?? ? ?783 ?? p?v9i ?4.e1oo . 7 : - $UILDtNG PERMIT Rtceipt # ' -? A re r....a ?. „1?!?:?t:L .?z, :?sr?•r. Est. Volue ' Dote ?-@??r.t?aTY 2 .. ..??..?.. Site Aderess 10F l 3ezver Dam Coiir± ?. Erect O Occuporyey R-3 1 tot F^ 61xk MPadowlai,d Sec/Sub. Aiter p Zoning r_ f Parcel # 10 4 3 01:i Cl 1103 (11 R"ir p Fire Zona ?:avi:3 J. "ICLe3i1 Enlo?s ? TYPe of Centt. n a Name M o v e O # S ro r i e s W Addross 1`'61 !yea ? vcr- Parr. Cour*_ Demotish p Length NA Tat;an !"S1^^ 454-775F: Groda p ? Depth Ft Sq ci phone . . Name ')wr? c r I?pp.orals Freir ? Address r:.., Name Addross Assessment Pe?mit '~ • ?`' .. Wote? & Sew. M. Surchorpe 1 . (TO ?'?? Police Plon cheek ? Fl n SAC ' Enp. Water Connr Pfanner Woter Meter Councii Rood Unit 1 hereby acknowledfle thot 1 hove reud this applicotian ond sfate that Bidp. Off. the infomwtion is wrtect ond ogree I+o corgply with ail opplicable ^PC TOW .. ..? .?; StaM of Minnesota Statutes and Gty M E,agyn Ordis. SiQnottue of Permittee avia--j.-yrrzIZan A Building Permit is issued ro: on rhe expro cwAtian Hw oll work sholi be dore in oooordanoe wlth oll cpplitobleySfote of Minne??t Stotutes ond Cify of Ecqmn OndinonaN. ? suikNl'p OffiC101 i i ' '/ ( •._ '-,c. - .,? t Pornit No. Parmk Hotdar Myc. Mrmit .. Ho. Hnldar Plumbing . ? . W.Y.A.C. ' w.c.. won - soww Etoatric T 10-7q ? ?It<< L$ ?'S"? InWfttion Dats hiv *. Other Footinip Faundotion Fmnino Rouqh Pibp. «"a' "'? 9 3 ° ,?7 . lnsm+atim FMd Pft - Finsl NVAC Fi" y? Oaoribs I.oation: 1Mq1 . sawr W.Ohp. ' . ? ? ..y / ? M ... vr? V?' LA\7AH ??" P16f ^nob R*W B"mI MM S5722 _ • FHONEe 4&8100 „ BUILDING FRMIT Te bs wed fvr SF DWG GAR Est, vaiue 8000 Do, ? 1961 Aeaver Ila m Ct- Site ?dd? E? ? y Lot 6 3 Blak Sec/Sub. 1JletidOXI9I1dS Altar Q Zaning Pa.cel # 10 48050 063 01 RepW. ? Fi.e zom CY1 ?i1??@ 0 - ??? T? 1Sf ,/??1?. cc Nome Joseph ?.![iller Construc. ' 0 mow LU 13015 Cedar Ave. S. Aaa?? o?isr? o k F?nr ? ?t ci Apple Va11ey,AWme 454-4753 Grada q D"th ?. ' e. Approm` ? =+ „ NaFne Z ot Addresc ,AssmssrWW* .9-10-. Pernrit a t; ul C Ph Water 8 Sew. I .;i 5undo?r? : • ZU ? . orre Polioe PFan d+eck .2-5 Name Fire SAC .. 523.04 ?Z x? Addne? Eng. ?Maisr ?C.a?rm7?:._... .' ? Ci Pl?n?te Plonner ` VYcftr ? " ' • ?' *:,'? Roa d ?? ??? i heretiy ocknowleclge thot 1 have reod H??is a{?plication aa?d stote that ? ?{. .. • the informotion is correet ond agree to eomply with oll eppliwble APC ? 5 7cft1 ? €r?ti? • 2 ,' i Staloe of Minnesoin Statwtas and City af Eog? Ordinanoes. , ,s ? . , $iynature of Permit{'ee ? ? ` /? Buitding Permit is inued ro: Joseph 2•."311er Constr . ?" o? the emp? OWNblift- oll woric shafl be done in aco?d?noe with otl opplionbfe State of Mimtiesata StotuCea wW C:IFy o?,&Wn y.. BuilcOng Offieid ` ? . ' ? . - j? . . . . .. .. ,. ?, a ?s'?.6 ? 3?',? •.? ' _ s Deb bmmd ? Plumbieq b fd ' - AAaci?aHaoi /b - ClJ - - p d, irVFC'rWM or+TE u?. ???a pmd Footings D - flWs Mw. Date Foundatton pkwnWna Fecmlir+s. -&}-p'c) Fincl p Rerrsork? I?l'?1 ?Ct? i3 cITV oF EaGaN PEAMM TvPE. 3830 Pilot Knab Road Perrnit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE QDDRE5S: N ' 10 - 4HW510 0 61 - 01 APPLICANT• • 1. !'! S : ?i ;;i F31. (.tE: lti t ?. I "t?v i t?,?tA V ?. r, r? A N ?-'3 ? ???r_? ?e ?????? ??a????r??; ?ta ?t???t.?t ?r?r.??? ? ?:; ? ? ??.? .? a ?a:p?w ? ,r?? . PERMIT SUBTYPE: TYPE aF IfVORK: :, T69M 0AMAJ;?-, t} IF, C'1 C 14 1 1"' 1 10 f9 0011.??"(4 Permft Na. Permit lia(der @ate Yeiephone # E1.ECTR1C PL3JMBEIVG ' k4VAuC tr+spm1on Date rnsp. corrkrnents F4OTNNGB . FC?UND FFiAdulI+lfa RC7OFING ROUGH PLUkMBII+Tt`a FLBG MR TfST Rt]UGH iifATlNG GAS SVC TE3T INSUL GYP BOARD FIREPi:ACE FIREPLRCE AIfl TEST FIM1AL PLBG FINAI. HTG ORSAT 7£St BLDG FINAL BSRAT R.I. BSMT FINAL DECK FTG DF_CK F9NAL ,- • ?? ? CITY OF EAGAN BLTILDIlVG PERMIT APPLICATION Include 2 sets vf plans, 1 site plan w/elevations & 1 set of energy calculations. Zb Be Used For R£"? Valuatian L? Date ? `G?' ' '?•? site Aaaress 1`01? or?IcE usE. onY LotIA(03 Blorat 0-1 sec./sub. occuparicy Paroel # : ? ? ?0r5v cCn ? ? Al.ter zon.i.ng ? I - Repair Fire Zone N 4 Owner: Enlarcje Zype of Const. Nbve # Stories Address: /l?(v / j3 ? fF d?/'?- ?i?-N? ?-?- Donolish Fmnt ft. Ci.,ty/Zip Cod,e; 2S- Grade Depth ft. Phon+e # : 7 Z5 61 APPRUVALS FM Contractor: Assessme.nts Permit ¢" 3 cV Address : Z?at?er/Sewer Surcharge l Police Plan Gheck City/Zip Code: Z-Fire SAC Water Conn. Phone #: 7 75 ? l?anuler Water Meter Council Road Unit _ Arch./Eng.. AfadreSS : city/zip Goae: Phone #: Bldg. Off. APC ----? ? ? ?s?--- 'POTAL .? 1 '.t , i ?? / - ?-?.F h ?. A'rY , ,. ., ? i ?1 .;?,,% ? f?? ? ? ? , ? ? n ? ? ; ' ///???...---???-???+! ?? i f /? ?r _ ?'? ! ?? ? ? n ? ?. ? ? ? r _,_ ? . ? 1'wT, . t??- ? ? ! ? ?( ? ? '? r. / ? . .. ? ---`-. " ?` ? ? _ _.•. _.?_ 1'_ _-_ '.. 1_2- (gerttftra#t of of eagan ? 39rvttrtnterif nf Nutlaing -Insprrtinn ;,. This Certif icatt i.rsuid pur.tuaru so thc nquiremenu o f Section 306 o f the Urjif orm Buildrng r.: Codc cntifring that at the time of is.ruancc thil structure wa.r in comQliancc urith the varior+.r ;Y ordinances o f thc City rcgulating building connruction or u.cc. For the f ollouring: I; ? SF DWG/GAR. eldg Pemdt No. 6212 r? OocuPa-,Y TYPe TYP Coosuuction v Fim Znaei Jn Zonin6 Disuict Rl Jos Mil er ConStr.Aaa?+ 13015 CPdar Ave S.Apple Va?; o.aer ot amdine ? 1961 Beaver Dam Ct L.,;,r L63 Bl, Meadowlands , '. _d%? By: 12-10-80 ? w? IM w coMMncuouS Rwcc ? .-%i?-. -,Q§wsv-, --qftwwp-?? IITHUiN 0 S.A. O?Oas +ea CITY QF EAGAN Remarks Addition Meadowland 1ST Additian Lot 63 -Eik 1 __ Parcei 14 48050 063 01 Owner 1-43 't , f 'X . Ll ?+ i 2 (i , Street 1961 Beaver ?0tt! Court Stste--- EagAil, MAi 55122 {mpravement Date Amount Annual Years Payment Receipt Date STREE'f SURF. STREET RESTOR. ' ?1?7. • 1431.00 A009789 ?.2 22 g0 GRADING SAN SEW TRUNK -"" ?970 ?7. 95 3.12 25 * SEWER LATERAL 6 SH 315.65 10 2 12 2 80 WATERMAIN * WATERIATEFAL 19g1 10 WATER AREA , r 1973 95.27 6.35 15 STORM SEW TRK 1971 2$2.92 14.15 20 * STQRM SEW LAT 1981 10 • services 10 GURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. FiUILDING PER. sAC 525.00 21152 10 1 80 PAR K M ; CfTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS; PERMIT PERMfT TYPE: BuILp zNG Permit Number: 028221 Date Issued: 07f10/96 1961 BEAVER C3AM CT L07': 63 BLOCK: 1 MEADOWLANDS 1ST P.I.N. : 10-48050--053-01 DESCRIPTIDN: (RvqFING) ermit Type QA,k Ty p e s-raRM oAMaeE F2EPAIf? 434 ALT. RESZDENTIWL ,?. .. . a ?.. REMARKS: FEE SUMMARY: ?wf b ' k-'? i?a3 P? -? CONTRACTOR: - Applicant - sT. LIC.OWIVER: sOB N soNs ROaFrntG 19201251 2001289 aLSaN nAN 4553 KERXES AVE S 1561 BEAVER C)AP1 GT MSNNERPqLIS MN 55410 EAGAN MN 55122 (612) 920-1251 (612)454-5314 z ; h e re b.v _w1e4 4?-It??? . d -r-e C?n E?t??n G4 L APPLICANTlPERMITEE SIGNATURE CITY OF EAGAN itm 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 nts RemodeURepair ? 3 registered aite surveys ? 2 copies of pian ? 2 oopies of plans (include beam b windew sizes; pou?ed fnd. desgn; etc.) ? 2 site surveys (exterior additions 8 dedcs) ? 1 ene?gy calculations ? 1 energy catculations for heated additions ? 3 copies of tree preseroation plan ff lot platted aRer 711193 required: Yes _ No DATE: ? ' 2-O --qL CONSTRUCTION COST: ? Z ? ? ? • ? DESCRIPTION OF WORK: L-`- ,' Vki STREET ADDRESS: 6 eow ev, LOT BLOCK o-LJiqos0 -0(o3-0 PROPERTY Name: dVSOr 1)a+,?'Phone #: OWNER • `"°* `M'T Street Address*- 1161 &Q,J-eK TIMm C'?. City: C ,??. State: Zip: Phone #: q Lo - ( 2S ? CONTRACTOR Company: ? ` % '? ¢ Street Address: ?; 3 6r SPs . S . License #: 0 ?? + ? 3 ?? ? City: ?l'?hrec?c.?<<S State: ? Zip:_ 5 , o ARCHITECT! Company: Phone #: ENGINEER Name: Registrativn #: Street AddressCity; State: Zip: Sewer & water licensed plumber: _ Penalty applies when address change and lot change are requested once permit is issued. i hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: `?-?- ? OFFICE USE ONLY Certificates of 5urvey Received Tree keservation Plan Received . SUBD.lP.I.D. #: Yes No Yes No . ,? OFFICE USE ONLY ? , . :.?. BUILDING PERMIT TYPE a 01 Foundation o 06 Duplex 0 02 SF Dweiling a 07 4-plex ? 03 SF Addition o 08 8-plex 0 04 SF Porch o 09 12-piex ? 05 SF Misc. 0 10 _ plex WORK TYPE 0 31 New o 33 Alterations 0 32 Addition * 34 Repair GENERAL tNFORMATION Const. (Actual) (Allowable) ? UBC Occupancy Zoning # of Stories Length Depth APPROVALS ? 11 Apt./Lodging ? 16 Basement Finish ? 12 Multi Repair/Rem. ? 17 Swim Pool 0 13 GaragelAccessory ? 20 Public Facility a 14 Fireplace C? 21 Miscelianeous 0 15 Deck a 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Engineering MC/WS System City Water Fire Sprinklered PRV Boos#er Pump Census Code. SAC Code Census Bidg Census Unit Variance .. Permit Fee Surcharge Plan Review License MCNVS SAC City SAC liriater Conn. Water Meter Acct. Deposit S1W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units ? ? L BL ? CITY USE ONLY ??a 8 q RECEIPT #: _ ( `4L RECEIPT DATE: ? ? 3 ?? SUdD • 1998 PLUMBING PERMIT (RESIDENTIAL) CZTY OF EAGAN 3830 PILOT IQdOH RD EAGAN, M 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system _____w- - --------- --------- --------- ---------- FIXTURES ------------------- EACH - -- # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x ° Kitchen Sink 3.00 x = Laundry Tray 3.00 x _ Hot Tub/Spa 3.00 x - Vftter Heater 3.00 x Floor Drain 3.00 x = Gas Piping Outlet * minimum - 1 3.00 x _ Rough Openings 1.50 x Water Softener ' for dwellings under construction 5.00 x Water Softener " for existing dwelling 20•00 X U.G. Sprinkler ' for dwelling under const. 3.00 _ U.G. Sprinkler ` for existing dwelling 20.00 _ Alterations "' to existing residence 20.00 Water Tum Around 20.00 - Private Disposal System " MPC iic. 75.00 = (new and refurbished systems) ' 00 2Q - Abandonment Private Disposal Systems . _ RPZ (new installation only) 20.00 STATE SJRCHARGE .50 TOTAL z0"50 ------------------------------------------------------- --- ------- ----------------------------------- --------------------- - I hereby adcnowledge that I have read thi- s --application, state that the i- nfo -r-m- ati--on-- is co-rrec-t-,-and ---- agree to comply with all applicable City af Eagan ordinances. It is the applicanYs respo' ` Eagan assumes no liability for any damages caused by the City during its n o r m al o perational and rr OLSON, DANIEL er this permit within City property/right•of-wayJeasement. 1961 BEAVER DAM SITE ADDRESS: EAGAN, MN 55122 (612) 454-9314 OWNER NAME: _ INSTALLER NAME: hI OQZl,01UI fllAm P?JmG TELEPHONE #: STREETADDRESS: CITY: /`? l I of? I?POLrt S _ STATE: Nt LJ- ZIP: O 51GNATURE?6F PEMTTEE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998 CITY OF EAGAN 'k • 3795 Pilot Kno6 Rwd Eagan, MN 55122 N! 6212 PHONE: 454-8100 BUILDING PERMIT APPLICATION Recetpt To be uted For SF DWG/G.AR Est. Value 38,000 Date l0-? , 19-8Q- Site Address 1-A61 BP3ver D= C;t Erect Xfj Occupancy R3 Lot 63 _ Block 1? Sec/Sub. Meadowlands Alter ? Zoning Rl- 10 48050 063 al Repcir ? Fire Zone 3 porcel # Enlorge Q 7ype of Const. V W Name Joseph Miller Canstruc. Mave [] # Stories 3 Address 13015 Cedar Ave. S. pemolish Q Front ?+5 ft. ° ci Apple Va11ey,IUha?e 454-4753 Grade ? Depth 37 ft. ce N m Appr'ovole Fees Zo a e SaEle Address ~ Ci Phone ? WW Name ?-?? Address azW CiN Phone I hereby ucknowledge thet I have read this application and state that the information is rnrrect and agree to comply with all opplicable Stote of Minnesota Stntutes ond City of Eagen Ordinances. AssessrrAQ 9-3n-80 Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit 11v. ?v Surchar9e 19.50 Plun check 55.25 sAC 525.00 Wcter Conn. 305.00 Wcter Meter 60 . 00 Road Unit 185.00 Totot 1; 260.25 Signuture of Permittee I A Buiidin9 Per,r,it is issued co: Joseph Miller Constr. on the express Condition thet olt work sholl be done in accord9mce with nll eppliceble Stnte of Minnesota Statutes ond City of Eagen Ordinances. Building Officicl ?-? ?,'i i 'Ib Be Used For New home Site Address 1961 B avee r Dam Ct. Ea an LOt 63 Block 1 Sec. Sub. ? Meadowland Parcel # : . Owner: Address: CitY/Zip Code: Phone #: . Contractor: Josenh Miller Const Co. Address: 13015 Cedar Ave. So. City/Zip Code: MN 55124 Phore # : - 454-4753 Axch. /Eng. Addres . City/Zip Code: Phone #: CITY OF EAC',AN BUILDING PERMIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations & 1 set of energy calculations. Valuation 38,000 Date 9/19/80 OFFICE USE ONLY Erect Occupancy ? 3 Alter - Zoning RePair Fire Zone EnlarSe ? Zype of Const. V A'bve # Stories Detrolish Front ft Grade . Depth -?------ ? 7 ft. APPROVALg FEES Assessnents . ? ermit Taater/Sewer S D, ? o Police Surcharge t,j?ro Plan Check ? .+r. a Fire g? Encj• Water Conn. Planner Water Nieter Council RQad Uni t?E??-. Q e Bldg. Off. APiC 'IC)TAL ? ., '• •Certificate Por: Dunn & Curry Jin Miller Const. DELMAR H. SCHWANZ LANDSURVEVOR R"ist*r*tl Under Laws oT Tht State ot Minnesota 2978 - 146TH STRHET W. - BOX M ROBEMOUNT, MINNESOTA 66066 PHONE 612 413-17N E3 7•90 N'1'3o S VEYOR'S CERTIFICATE ?. 4• ?9'9 (__j?_j)ENOTES 'RoPost o FtIJIsV*p Qft1 __..? 1!e'460 ? l ? r ? -.? \ k 190 ? . ? \ 6 .? ?2 \ ? tBHk _ q d '.? 45P7 '' _ .. I hereby certify that this is a true and correct representation of 00 Lot 63, Block 1, MEADOWLAND FIRST ADDITION, according to the recorded t? R 'p;?,M Gpy?,T? plat thereo£, Dakota County, Minnesot?:?J? Dated: June 16, 1980 Approved for Dunn & Curry Real Estate Management, Ine. by: A18o showing the proposed location of a houae. Da,ted: September 12,1980. QEaseo 140.hm 9_ i(*-+9t0 \ z8' ?> 1 J ? R--- 4T.?9 ?.? ? MINNESOTA REGIST ATION N0.8825 ? • • • •- owi4Liz: SITL•' ADUF1:5S: nnxL ?? ????? -- PIiONE: CONTRAC'1OR: 1 Aetexmine working square,footage of each 1, ToCal CY.OOSCd wall arca ...... Li-I 'a? sq. ft. x .17 • 41 ? .1_ 0'? 2. 7'ati]. ruoi?/?e:.ling arca ...... .._4- sq. ft. x .05 ° d Total ex}:osed wall area nbove floor = 157 . • ? .? a. Tota]. wall windiw area ................................. .... i... t.:.3. !!:`:!C -iYC!ii ............................ ....... C. TJ ?:iZ dJUr area . . . . . . . . • . . . . . . . . . . . . . . .. ___? d. Tot:dl LirepIace wali area ............................. Q. Tot:xl ?tall fra,niny arca (averagc 10%) . . . . . . . ... .. . ... . . ?. f. Total rim joist araa .................................. ZI ? g. L)Err wal]. area above floor .......................... h. aren aboye r .......................... . i. .......................... . j• = "+. . .......................... -- vieotal e%posed foundation area = V ? ::1,1tion wi.ridnw ar..:a ........................... k. t1 io, 11 1. `Pr,r.al net £oundation area above grade ................. , peCcr.mine "U" (e.g. window, valuc of each wall segment door, each separate wall section) a. , x .-U,. b. x „u,. C ?? . CA x „U„ 42 . d. ? v fltllF _ -• -------- e. /Sx .,LI„ 0/ 2 - I t .?1, ? 9 x "U„ • _._ -- ? ? • X . __ .__ ------- "U" " --------°- ?' _____ __ r _ ' X "u " ? • __.?__?---- __._...?_ ? X "U'` ' 1. . ._ __.._ . _ . . __ _ .. _...__ ____.._ ._.. ?_..... ? . •- - - - ?`.'? '?_ h "U" ? . C,??__._ :? ?• ? b . . . , . xotal F;::TI:RIOIt L".1VELOPIi I:VI.(J1(;E "U" COMPL'TATIUN 'tL x?cia 113 is thc sarne c ? cSr' les: Chan itcm ;I1, yc 1iuvA met thv inCent c:t ;;li,^. GfrUfi (C) 2. I ?•'"Cxt;?rior Envclope Averane "l1" ComputaLion . , Tuta1 exposed roof/coiling area m. 7bta1 skyliglit area ............................ " n. Total. roof/cei.] i nt-t framinry arr,;? (avcr.a?je o. Total net ira:ulated roof/ceiling area........... Uetermine "v" valuc for each roof/ceiling segment X n . x _--- o. -7 Co . l x„u„ 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 7btal Page 2 of 4 Ii tota.l of 44 is t]ie swne as, or less than #2, you have met the intent of Stic, 00051 (c) 1. Alternare fiuilding Fnvelope Design _ Zb utilize the total envelope system method, the values astablished by the s•,un of itun:; 113 and.#4 shall nat be greater than the sum of ittms Nl and #2. 1. 30 I,? ? + z. 3. Z3? . I + 4. 1 r , CITY OF EAGAN ^ 3830 Pilot lCnob Road, P.O. Box 21-199, Eagan, MN 55121N2 12154 BUILDING PERMIT PHONE:454-8100 ReceiPt # G- To be used tor DECK Est. Value $ 2,0 0 0 Date JLINE 23 19 86 Site Address 19 61 BEAVER DAM CT Erect C11 Occupancy Lot 063 glock 01 Sec/Sub. MEADOWLANDS 1STRemodel ? Zonino Parcel No. Repair ? Type of Const. Addition ? No. Stories W Name KURT LAWTON nnove ? Length 16 SAME 456-5677 Demolisn ? Depth N} o Address Int. Impr. ? Sq. Ft City Phone 690 7252 (W) Install ? ¢ S? Approvals Fees . o Name z ?- 0 de Address ~ City Phone ? F W Name v ? Address e W Ciry Phone Assessment _ Water & Sew. Police Fire Eng Planner Council Permit $ 3 2 . 5 0 Surcharge 1.00 Plan Review SAC Water Conn. Water Meter Road Unit I hereby acknowledge that I have read t is application and state thatthe gldg. Off. 6/23/86 Tr. PI. information is correct and agree to m y with all a licable State of Minnesota Statutes and Ci an i anc APC PaYks VA, Var. Date Copies $33.50 Signature of Permittee Totai A Building Permit is issued to: KURT LAWTON on the express condition that all work shall be done in accordance with all ap ca of in s?Sta u? d i agan Or nces. Building Official ?- - - 1986 BIIILDIAG PSRKIT APPLICATIOH - CITY OP' SAGAN NOYS: ALL CONTRAC?OHS MI1ST B8 LICEBSED iTITH THB CITY OF SAGAN SIAGLE FAMIILY DWELLINGS INCLUDE 2 5ETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWfiLLINGS - RESIDSNTIAL. RENTAL DNITS FOR SgI.S ONITS INCLUDE 2 SETS OF PLANS, CER'PIFIC9TE OF SORV6Y - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCIILATIONS COM?I'sRCIlI. INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: ??ec Site Address I 7CP 1 Lot 6 ? ?3loek C) I & STRUCTORAL PLANS, SET OF Valuation: ? Parcel/Sub 'JY?.???? )'-? Owner Z-a I,o?m Address 1961 aavet e. City/Zip Code Phone Contractor SPI ? Addreas City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # Date: -l - ? Erect ? Oecupancy Remodel Zoning Repair Type of Const Addition # of Stories Move Length ? Demolish Depth f? Int.Impr. Sq Ft Install APPR09ALS FEES Assessments Permit Water/Sewer Sureharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Treatment P1 APC Parks Varianee Copies ?OTAL NOTE: ADDBESSES FOR CORNER LOTS - CONTRiCTOR/flO1rIE0WNEE MUST DESIGNITE WHICH ADDRE3S IS DESIRED. NO CHANGES WILL BE AI.LOTi'ED ONCE BOILDING PSRMIT IS ISSIIED. ? cD . ? ? ?? ? ?: ?/8 „-- 1, ..?? ? ' ? r " ? ?, • 19?1 t3 ? ?= `,' :_ ?- .?,? 1?? CT . cA G? N, NIN s?! ?? ?wNE E S FL F klvl, 6q0- 7252 41 V r ?- H /, G( M.8 ER=Tr'D Gvonz to,e : (-4.z 4- a rR 54 S KD TiPFi4Tt-p P6 N.D ERw filN?-) •ShfeY,or Jo1 5is + &dr?s O-IrdFvtar vlOCk,':t3 ',ifd ileir o r, rta u s E'_ ' Pos eS RE.LWOOL t0? : • E??d ? o ??Sf 5 • .De ck ?'?9 • l?a, ?s o. ?'aps • S-f d? K--- 66' cor L/NF LoT L1 NF i Qg, I LoT L/NF .rl756I 2007 RESIDENTIAL BUILDING PExMIT arPr.icaTiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements 3 registered site surveys showing sq, ft. of lot, sq. ft. of house; and all roofed areas (209`o maximum lot coverage allowed) 1 Soils RepoR if proposed building is to be placed on disturbed soil 2 copies of plan showing beam & window sizes; poured found design, eic. 1 set of Energy Calculations 3 copies of Tree PreservaGon Plan if lot plafted after 711193 Rim Joist Dehail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form RemodeURepair Reouirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Add'dion - indicete if on,s'rfe septic system ptan-q arP r_nns«iprPd nueiic infarmation unless vou state thev are trade secret and the reason. Date Site Address ? I? Construction Cost ? Qeo?u' ?? ??'^^ ?• Unit/Ste # ?a? qr M 1? J S 1 ZZ Description of Work ?..1 E? Multi-Family Bldg _ Y/ N Fireplace(s) _ 0 2 Property Owner -'DG t v, £ K&uY 4 Telephone # ( ?OS ( ) `4 S `{ Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Categor?l _ Minnesota Rules 7672 Energy Code Category • Residentiai Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( Telephone # ( e??.6,5?) Office Use Oniv Cert of 5urvey Recd _ Y_ N Soils Repod _ Y _ N Tree Pres Plan Recd _Y _N, Tree Pres Required _ Y_ N On-5ite Septic System _ Y_ N I hereby apply for a Residential Building Permit and acknowledge that the information is compiete ana accurate; that the work will be in conformarice with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 0 Applicant's rinted Name ,Q,?,-? ? Applicant's ' ature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation 0 02 SF Dwelling O 03 01 of _ plex ? 04 02-plex ? 05 03-plex 0 06 04-plex Work Tvpes ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement ? 07 05-plex ? 08 06-plex ? 09 07-plex ? 10 08-plex ? 11 10-plex ? 12 12-plex DesCClption: Water Damage ? 13 16-plex ? 16 Fireplace ? 17 Garage ? 18 Deck ? 19 Lower Level ? 20 Pool ? ? 21 Porch (3-sea.) ? ? 22 Porch/Addn. (4-sea.) ? ? 23 Porch (screen/gazebo/pergola) ? ? 24 Storm Damage 0 25 Miscelianeous 30 Accessory Bldg 31 Ext. Alt - Multi 33 Ext. Alt - SF 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg) - Give PCA handout to applicant Yes Valuation Occupancy MCES System Plan Review 100% or 25% Code Edition Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) Sheetrock _ Footings (deck) FinaUC.O. _ Footings (addition) Fina]!No C.O. _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final _ Framing Siding Stucco Lath Stone Lath Brick _ Fireplace _ R.I. _ Air Test _ _ Final _ _ _ Windows _ Insulation _ _ Retaining Wall Approved By: Base Fee Surcharge Pfan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA119648 Date Issued:12/11/2013 Permit Category:ePermit Site Address: 1961 Beaver Dam Ct Lot:063 Block: 1 Addition: Meadowlands 1st PID:10-48050-01-063 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater & Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Daniel Olson 1961 Beaver Dam ct Eagan, MN 551222221 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Daniel R Olson 1961 Beaver Dam Ct Eagan MN 55122 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA119689 Date Issued:12/12/2013 Permit Category:ePermit Site Address: 1961 Beaver Dam Ct Lot:063 Block: 1 Addition: Meadowlands 1st PID:10-48050-01-063 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Greg Martin 14105 Rutgers St Ne Prior Lake, MN 55372 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Daniel R Olson 1961 Beaver Dam Ct Eagan MN 55122 Appliance Installers Of Mn 14105 Rutgers St NE Prior Lake MN 55372 (952) 469-8341 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK 1 For Office Use '1 Eapli Perm #: /CltOl 4Permit Fee: J2�'b 3830 Pilot Knob Road Eagan MN 55122 r j Date Received; .0"7 /7 Phone:(651)675-5675 buiidinoinspections@citvofeaoan.com Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION 10-16-2017 1961 Beaver Dam Court Eagan, MN 55122 ?� Date: Site Address: Unit#: Dan and Mary Ann Olson 651-500-9651 Name: Phone: Resident! 1961 Beaver Dam Court Eagan, MN 55122 Owner Address/City/Zip: X Applicant is: Owner Contractor Bathroom remodel Type Of Work Description of work: $10,067 X Construction Cost: Multi-Family Building:(Yes T/No ) Koster Construction Inc. Jared Koster Company: Contact: 3991 Lakewood AVE White Bear TWP Contractor Address: City: MN 55110 612-720-3764/ jrkoster@kosterconstruct.com State: Zip: Phone: Email: BC726973 License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: Home was built in 1980 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(661)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in confo nce with the ordinances and codes of the City of Eagan;that I understand this is not a permit, but only an application for a permit, and work' to start without a permit-; hat the work will be in accordance with the approved plan in the case of work which requires a review and approv,, pl s. Jared Koster x Applicant's Printed Name Applicant's Signature Page 1 of 3 06 441/64- D11)- DO NOT WRITE BELOW THIS LINE /V' .--? 'V SUB TYPES _ Foundation — Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) 4, Single Family — Garage — Porch(4-Season) _ Exterior Alteration(Multi) _ Multi — Deck _ Porch(Screen/Gazebo/Pergola) — Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New — Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall "Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation )1 l9 (9 0 Occupancy j 'j MCES System Plan Review Code Edition vevrvsn,of SAC Units (25%_100% k) Zoning 1'b City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction /h Width REQUIRED INSPECTIONS �J Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required — Footings(Addition) \L. Final/No C.O.Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test — Roof: Ace&Water _Final Pool:_Footings _Air/Gas Tests _Final — Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding: Stucco Lath _Stone Lath Brick_EFIS Insulation Windows — Sheathing Retaining Wall:_Footings_Backfill—Final — Sheetrock Radon Control — Fire Walls Fire Suppression:_Rough In_Final — Braced Walls Erosion Control — V Shower Pan Other: Reviewed By: IL. , Building Inspector RESIDENTIAL FEES Base Fee Surcharge /f y Plan Review `1 ("( ° MCES SAC 0 f°1 City SAC Utility Connection Charge S&W Permit&Surcharge 0 u7 V Treatment Plant ,�-Ao9 , „2. Copies 1 TOTAL Page 2 of 3 Use BLUE or BLACK Ink For Office Use tf3a1) Cityof Eaa� Permit#:Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Staff: buildinginspectionsacityofeagan.com 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: I- '" 1-3 tZ Site Address: A5t 6 G-ew\ie,l' j a ‘A./\ C Tenant: Suite#: Resident/ YUnet Name: a vn t 0 ( S a U7 Phone: ` Address/City/Zip: 9 /4 t3 ecw LC 6-k vr�t C I..� ea A4 ti' Name: License#: Contractor Address: City: State: Zip: Phone: Contact: Email: New Replacement !Repair _Rebuild _Modify Space Work in R.O.W. Type of Wore — — — Description of work: e��n �..� r I( i vu l p� I A s�.w✓c.1) 7 vy �," RESIDENTIAL 5' u nc P mel a�G �cnnrT Y s0-114- . Water Heater Lawn Irrigation ( RPZ/_PVB) Water Softener Permit Type Septic System Add Plumbing Fixtures( Main/_Lower Level) New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) - $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. „ \el ( 5 cv\ c w2(-P Applicant's Printed Name Applicant's Signature FOR OFFICE USE t ,' : :Reviewed Ry Date: Required Ilnspections Under trot nd : Rough-In Alr Test Cas Test Final Meter Related Items : Meter Size Radio Read Manometer Staff:.